Cued Overeating

  • Anita Jansen
  • Remco C. Havermans
  • Chantal Nederkoorn


The cued overeating model that is presented in this chapter states that cues that reliably signal highly palatable food intake – such as the sight, smell, and taste of highly palatable foods – and also the context in which (over)eating takes place – like place and time and feelings and thoughts – may start to act as conditioned stimuli. This means that soon after, the cues alone can trigger food cue reactivity and food cravings. The learned cue reactivity increases the probability of (over)eating and might sabotage dieting. It is argued that for successful dieting it is necessary to extinguish learned cue reactivity. To reach that goal, the way of dieting is relevant: dieters who avoid highly palatable food cues and dieters who intermittently keep eating high-calorie high-fat palatable foods will remain cue reactive. Only dieters who expose themselves to highly palatable food cues without eating them are expected to show the desired extinction of cue reactivity. Extinction of cue reactivity can be accelerated by prolonged cue exposure with response prevention. During the exposure the overeater is exposed to the cues (e.g., smell and sight of tasty foods) that elicit appetite or craving. The exposure is long lasting and without eating. Whether cue exposure with response prevention is an effective intervention that promotes successful dieting remains to be studied.


Conditioned Stimulus Anorexia Nervosa Unconditioned Stimulus Binge Eating Bulimia Nervosa 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



World Health Organisation


Conditioned stimulus (= cues)


Unconditioned stimulus


Unconditioned response


Conditioned response


Cognitive behaviour therapy


  1. American Psychiatric Association. Comittee on nomenclature and statistics: diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
  2. Boggiano MM, Dorsey JR, Thomas JM, Murdaugh DL. The Pavlovian power of palatable food: lessons for weight-loss adherence from a new rodent model of cue-induced overeating. Int J Obes. 2009;33:693–701.CrossRefGoogle Scholar
  3. Bouton ME, Woods AM, Moody EW, Sunsay C, Garcia-Gutierrez A. Counteracting the context-dependence of extinction: relapse and tests of some relapse prevention methods. In: Craske M, Hermans D, Vansteenwegen D, editors. Lear and fearning. From basic processes to clinical implications. Washington, DC: APA; 2006. p. 175–96.CrossRefGoogle Scholar
  4. Bruce B, Agras W. Binge eating in females: a population-based investigation. Int J Eat Disord. 1992;12:365–73.CrossRefGoogle Scholar
  5. Bulik CM, Sullivan FA, Carter FA, McIntosh VV, Joyce PR. The role of exposure with response prevention in the cognitive-behavioural therapy for bulimia nervosa. Psychol Med. 1998;28:611–23.PubMedCrossRefGoogle Scholar
  6. Carter FA, Bulik CM. Exposure treatments for bulimia nervosa: procedure, efficacy, and mechanisms. Adv Behav Res Ther. 1994;16:77–129.CrossRefGoogle Scholar
  7. Deutsch R. Conditioned hypoglycemia: a mechanism for saccharin-induced sensitivity to insulin in the rat. J Comp Physiol Psychol. 1974;86:350–8.PubMedCrossRefGoogle Scholar
  8. Gorin AA, Phelan S, Wing RR, Hill JO. Promoting long-term weight control: does dieting consistency matter? Int J Obes. 2004;28:278–81.Google Scholar
  9. Havermans RC, Mulkens S, Nederkoorn C, Jansen A. The efficacy of cue exposure with response prevention in extinguishing drug and alcohol cue reactivity. Behav Interv. 2007;22:121–35.CrossRefGoogle Scholar
  10. Herman CP, Mack D. Restrained and unrestrained eating. J Pers. 1975;43:647–60.PubMedCrossRefGoogle Scholar
  11. Jansen A. A Learning model of binge eating: cue reactivity and cue exposure. Behav Res Ther. 1998;36:257–72.PubMedCrossRefGoogle Scholar
  12. Jansen A, van den Hout M. On being led into temptation: ‘counterregulation’ of dieters after smelling a ‘preload’. Addict Behav. 1991;5:247–53.CrossRefGoogle Scholar
  13. Jansen A, van den Hout M, van Loof C, Zandbergen J, Griez E. A case of bulimia succesfully treated with cue exposure. Behav Ther Exp Psychiatry. 1989;20:327–32.CrossRefGoogle Scholar
  14. Jansen A, Broekmate J, Heymans M. Cue exposure vs self-control in the treatment of binge eating: a pilot study. Behav Res Ther. 1992;30:235–41.PubMedCrossRefGoogle Scholar
  15. Jansen A, Theunissen N, Slechten K, Nederkoorn C, Mulkens S, Roefs A. Overweight children overeat after exposure to food cues. Eat Behav. 2003;4:197–209.PubMedCrossRefGoogle Scholar
  16. Jansen A, Vanreyten A, van Balveren T, Roefs A, Nederkoorn Ch, Havermans R. Negative affect and cue-induced overeating in non-eating disordered obesity. Appetite 2008;51:556–62.PubMedCrossRefGoogle Scholar
  17. Jansen A, Stegerman S, Roefs A, Nederkoorn C, Havermans R. Decreased salivation to food cues in formerly obese successful dieters. Submitted for publication; 2009.Google Scholar
  18. Marcus MD, Wing RR, Lamparski D. Binge eating and dietary restraint in obese patients. Addict Behav. 1985;10:163–8.PubMedCrossRefGoogle Scholar
  19. Martinez-Mallén E, Castro-Fornieles J, Lazaro L, Moreno E, Morer A, Font E, Julien J, Vila M, Toro J. Cue exposure in the treatment of resistant adolescent bulimia nervosa. Int J Eat Disord. 2007;40:596–601.PubMedCrossRefGoogle Scholar
  20. Mattes RD. Physiological responses to sensory stimulation by food: nutritional implications. J Am Diet Assoc. 1997;97:406–12.PubMedCrossRefGoogle Scholar
  21. Nederkoorn C, Jansen A. Cue reactivity and regulation of food intake. Eat Behav. 2002;3:61–72.PubMedCrossRefGoogle Scholar
  22. Nederkoorn C, Smulders F, Jansen A. Cephalic phase responses, craving and food intake in normal subjects. Appetite 2000;35:45–55.PubMedCrossRefGoogle Scholar
  23. Overduin J, Jansen A. Conditioned insulin and blood sugar responses in humans in relation to binge eating. Physiol Behav. 1997;61:569–75.PubMedCrossRefGoogle Scholar
  24. Overduin J, Dworkin BR, Jansen A. Introduction and commentary to: Mityushov, M.I. (1954): conditioned reflex secretion of insulin. Integr Physiol Behav Sci. 1954;32:228–46.Google Scholar
  25. Power ML, Schulkin J. Anticipatory physiological regulation in feeding biology: cephalic phase responses. Appetite 2008;50:194–206.PubMedCrossRefGoogle Scholar
  26. Powley T. The ventromedial hypothalamic syndrome, satiety and a cephalic phase hypothesis. Psychol Rev. 1977;84:89–126.PubMedCrossRefGoogle Scholar
  27. Raynor HA, Jeffery RW, Phelan S, Hill JO, Wing RR. Amount of food group variety consumed in the diet and long-term weight loss maintenance. Obes Res. 2005;13:883–90.PubMedCrossRefGoogle Scholar
  28. Rodin J. Insulin levels, hunger, and food intake: an example of feedback loops in body weight regulation. Health Psychol. 1985;4:1–24.PubMedCrossRefGoogle Scholar
  29. Rolls ET, Rolls JH. Olfactory sensory-specific satiety in humans. Physiol Behav. 1997;61:461–73.PubMedCrossRefGoogle Scholar
  30. Siegel S. Conditioning of insulin-induced glycemia. J Comp Physiol Psychol. 1972;78:233–41.PubMedCrossRefGoogle Scholar
  31. Siegel S. Classical conditioning, drug tolerance and drug dependence. In: Israel Y, Smart FB, editors. Research advances in alcohol and drug problems, vol 7. New York: Plenum; 1983. p. 207–46.Google Scholar
  32. Stice E, Bohon C, Fischer K. Subtyping women with bulimia nervosa along dietary and negative affect dimensions: further evidence of reliability and validity. J Consult Clin Psychol. 2008;76:1022–33.PubMedCrossRefGoogle Scholar
  33. Toro J, Cervera M, Feliu MH, Carriga N, Jou M, Martinez E, Toro E. Cue exposure in the treatment of resistant bulimia nervosa. Int J Eat Disord. 2003;34:227–34.PubMedCrossRefGoogle Scholar
  34. Wadden TA, Brownell KD, Foster GD. Obesity: responding to the global epidemic. J Consult Clin Psychol. 2002;70:510–25.PubMedCrossRefGoogle Scholar
  35. Wardle J. Conditioning processes and cue exposure in the modification of excessive eating. Addict Behav. 1990;15:387–93.PubMedCrossRefGoogle Scholar
  36. Weingarten H. Conditioned cues elicit feeding in sated rats: a role for learning in meal initiation. Science 1983;220:431–2.PubMedCrossRefGoogle Scholar
  37. Wing RR, Hill JO. Successful weight loss maintenance. Annu Rev Nutr. 2001;21:323–41.PubMedCrossRefGoogle Scholar
  38. Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr. 2005;82(suppl):222S–5S.PubMedGoogle Scholar
  39. Woods SC. The eating paradox: how we tolerate food. Psychol Rev. 1991;4:488–505.CrossRefGoogle Scholar
  40. World Health Organisation (2009).

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Anita Jansen
    • 1
  • Remco C. Havermans
  • Chantal Nederkoorn
  1. 1.Department of Clinical Psychological ScienceMaastricht UniversityMaastrichtThe Netherlands

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